Coding, documentation, and compliance... Oh My! RSS 2.0
# Friday, June 05, 2009

I still get this question quite routinely.  'Can't I only use 99211 for a nurse-only visit?'  The description of 99211 indiates that the physician's presence is not required.

The physician presence statement in CPT is not applicable to the Hospital Outpatient Prospective Payment System (HOPPS).  CMS instructed hospitals to develop their own criteria for the assignment of these E/M codes.

For the facility portion of a followup encounter, where ONLY the nurse saw the patient, the hospital may bill 99211 through 99215 depending on the hospital's self-developed criteria.

Friday, June 05, 2009 11:07:57 AM (Central Daylight Time, UTC-05:00)  #    Comments [0] -
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